Screening for Psychological Illness in Military Personnel

Rona, Roberto J.; Hyams, Kenneth C.; Wessely, Simon

doi:10.1001/jama.293.10.1257

Cited by 81 publications

(71 citation statements)

References 24 publications

(36 reference statements)

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“…Similar conclusions were reached in a commentary recently published in the Journal of the American Medical Association (Rona, Hyams, & Wessely, 2005). In their discussion of the conditions under which psychological screening of military personnel is warranted, Rona and collegues argued that such screening is ill-advised without evidence of its effectiveness, and identified a number of possible risks of screening, including limitations in confidentiality; lack of honest responding due to lack of trust in military mental health programs and providers or fears of possible stigmatization and adverse career consequences; and decreases in morale.…”

Section: Discussionsupporting

confidence: 87%

Posttraumatic stress symptoms in Navy personnel: Prevalence rates among recruits in basic training

Stander¹,

Merrill²,

Thomsen³

et al. 2007

Journal of Anxiety Disorders

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Section: Discussionsupporting

confidence: 87%

Posttraumatic stress symptoms in Navy personnel: Prevalence rates among recruits in basic training

Stander¹,

Merrill²,

Thomsen³

et al. 2007

Journal of Anxiety Disorders

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“…Little evidence exists, however, that such pre-service screening has a significant impact on the ultimate rates of disorders either in the military or in these settings. 31 Rather, the critical factor is the intensity and nature of the exposures that individuals have to contend with and the associated organisational supports. 32 In general, the literature supports the notion that it is the exposures of the officers to particular incidents, particularly large-scale natural disasters or incidents involving deaths of children that play an important role in the onset and continuation of post-traumatic stress disorder.…”

Section: Discussionmentioning

confidence: 99%

The impact of traumatic stressors in civilian occupational settings

McFarlane

Williamson

Barton

2009

J Public Health Pol

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We use the literature reporting prevalence and aetiology of post-traumatic stress disorder (PTSD) in first responders as a catalyst to discuss for organisations the policy implications for prevention and intervention of psychiatric morbidity. We searched PubMed and Google to identify studies and reports of mental health and behavioural problems in occupations including police, fire, and emergency service workers. The prevalence of PTSD ranged from 6 per cent to 32 per cent. Biological markers of PTSD, such as neuroendocrine activity, appear less useful than psychological markers, such as levels of hostility and self-efficacy, to predict PTSD. Prevalence of PTSD was generally less than that found among victims themselves, but higher than general community prevalence. Theoretically, if prevention and intervention strategies were working effectively, there should be a minimal rate of psychiatric morbidity attributable to these individuals' workplaces. Against this background, there is a case for routine screening on an annual basis for those at risk.

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“…The screening procedure includes educational achievement and a brief psychological evaluation, and is aimed to screen out applicants with clear psychological problems (RTO 2000;Cardona and Ritchie 2007). It appears that, currently, applicants are not screened specifically for vulnerability to PTSD due to lack of evidence on screening for this purpose (Jones, Hyams, and Wessely 2003;Rona et al 2005). However, the screening instruments are used to filter out applicants with a current psychological disorder as well as those who seem to be unfit for military service for other reasons (Jones, Hyams, and Wessely 2003;Rona et al 2005).…”

Section: The Military Ptsd-infrastructure and Its Institutional Narramentioning

confidence: 99%

Conflicting Notions on Violence and PTSD in the Military: Institutional and Personal Narratives of Combat-Related Illness

Molendijk

Kramer

Verweij

2015

Cult Med Psychiatry

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Research indicates that soldiers struggling with PTSD under-utilize mental health care. Quantitative studies of barriers to care point to the importance of soldiers' beliefs about mental health and mental health interventions in their care-seeking behavior, yet these studies still struggle to understand the particular beliefs involved and the ways they impact care-seeking behavior. This preliminary study makes a start in examining these questions through qualitative literature analysis. It maps out dominant messages surrounding PTSD in military mental health interventions, and explores how they can both shape and conflict with soldiers' personal notions. It does so by analyzing these messages and notions as institutional and personal (illness) narratives. Institutional military PTSD-narratives, which draw on mainstream scientific and clinical models, appear to communicate contradictory notions on the meanings of violence and its psychological consequences, often without acknowledging these contradictions. As such, these narratives seem to shape struggles of soldiers, both within themselves and with the military institution. The identified conflicts indicate, contrary to the individualizing and decontextualizing focus of dominant PTSD-understandings, that soldiers' struggles also have social and moral dimensions. This has important implications for both research into PTSD-interventions and understandings of PTSD as such.

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Screening for Psychological Illness in Military Personnel

Cited by 81 publications

References 24 publications

Posttraumatic stress symptoms in Navy personnel: Prevalence rates among recruits in basic training

Posttraumatic stress symptoms in Navy personnel: Prevalence rates among recruits in basic training

The impact of traumatic stressors in civilian occupational settings

Conflicting Notions on Violence and PTSD in the Military: Institutional and Personal Narratives of Combat-Related Illness

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